Cumulative Probability and Time to Reintubation in U.S. ICUs

Area of Science:

• Critical Care Medicine
• Respiratory Therapy
• Health Services Research

Background:

• Reintubation following mechanical ventilation is a significant adverse event in intensive care units (ICUs).
• Standardized definitions and reporting are crucial for accurate benchmarking and quality improvement.

Purpose of the Study:

• To determine the frequency of reintubation in U.S. ICUs.
• To propose a standard time cutoff for reporting reintubation events.

Main Methods:

• A cohort study was conducted using data from the Project IMPACT database.
• 185 diverse U.S. ICUs were included, analyzing data from 98,367 patients who received mechanical ventilation.

Main Results:

• 10.1% of extubated patients required reintubation, with a cumulative probability of 10.0%.
• The median time to reintubation was 15 hours.
• 90% of reintubations occurred within 96 hours of initial extubation, consistent across patient and ICU subtypes.

Conclusions:

• The reintubation rate in U.S. ICUs is approximately 10%.
• A 96-hour time cutoff is proposed for defining and reporting reintubation events, capturing the vast majority of occurrences.
• Reintubation rates can be reported as simple percentages, simplifying benchmarking.